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NPI Code Detail

MEDICARE: DAYMARK RECOVERY SERVICES, INC.

MEDICARE: DAYMARK RECOVERY SERVICES, INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional Counselor
2103TC0700XClinical Psychologist
31041C0700XClinical Social Worker
4106H00000XMarriage & Family Therapist
5261QM1300XMulti-Specialty Clinic/CenterMHL-029-032NC
6101YM0800XMental Health Counselor

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1396885711
Entity Type Code : Organization
Provider Name (Legal Business Name) : DAYMARK RECOVERY SERVICES, INC.
Provider Business Mailing Address
First Line : 284 EXECUTIVE PARK DRIVE
Second Line : SUITE 100
City : CONCORD
State : NC
Zip : 28025-1833
Country : US
Telephone Number : 704-939-1100
Fax Number : 704-939-1173
Provider Business Practice Location Address
First Line : 1104 A SOUTH MAIN ST
Second Line :
City : LEXINGTON
State : NC
Zip : 27292-3134
Country : US
Telephone Number : 336-242-2450
Fax Number : 336-249-9920
Authorized Official
Title or Position : PRESIDENT
Name : MR. BILLY R WEST JR.
Credential :
Telephone Number : 704-939-1100
Provider Enumeration Date : 02/07/2007
Last Update Date : 09/01/2016

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Practice Fax: 336-249-9920

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